常见异常血红蛋白对4种离子交换高效液相色谱法检测糖化血红蛋白的影响

Effects of common hemoglobin variants on 4 ion exchange high performance liquid chromatography methods based HbA1c measurements

目的评价常见的7种异常血红蛋白对4种离子交换高效液相色谱法检测糖化血红蛋白的影响。方法收集2017年1月至2018年2月北京大学深圳医院检验科糖化血红蛋白检测过程中发现的异常血红蛋白全血样本95份。采用毛细管电泳法（Sebia Capillary 2 Flex Piercing）和4种离子交换高效液相色谱法（Bio－Rad D－10，Arkray HA8180V，Tosoh G8，以及MQ6000 Plus）测定全血样本，检测常见的7种异常血红蛋白（Hb E、Hb New York、Hb J－Bangkok、Hb G－Coushatta、Hb G－Taipei、Hb Q－Thailand、以及Hb G－Honolulu），以毛细管电泳法作为参比方法，分析7种异常血红蛋白对4种离子交换高效液相色谱法检测糖化血红蛋白结果的影响。统计分析采用SPSS 19.0软件，计算异常血红蛋白样本的平均偏倚，并用箱式图来显示偏倚分布。结果4种离子交换高效液相色谱法都不能分离异常血红蛋白Hb New York，但对糖化血红蛋白检测结果的影响均在临床可接受范围内。D－10能够识别6种异常血红蛋白，Hb J－Bangkok、Hb G－Coushatta和Hb G－Taipei干扰D－10的糖化血红蛋白结果。HA8180V快速模式未给出Hb J－Bangkok、Hb G－Coushatta、Hb G－Taipei的结果，Hb E、Hb Q－Thailand和Hb G－Honolulu的结果出现显著负偏。G8标准模式识别1种异常血红蛋白，6种异常血红蛋白结果出现显著负偏。MQ6000 Plus能够分离6种异常血红蛋白，Hb G－Coushatta、Hb G－Taipei的结果出现显著负偏。 结论常见异常血红蛋白对某些离子交换高效液相色谱法产生干扰，可导致糖化血红蛋白结果错误。

ObjectiveTo evaluate effects of 7 common hemoglobin variants on HbA1c measurements using 4 ion exchange high performance liquid chromatography methods.MethodsNinety five samples with hemoglobin variants were collected from January 2017 to February 2018 during HbA1c measurements in laboratary medicine of peking university shenzhen hospital. Samples with 7 common hemoglobin variants were measured using Sebia Capillary 2 Flex Piercing, Bio-Rad D-10, Arkray HA8180V, Tosoh G8, and MQ6000 Plus, respectively. Effects of 7 common hemoglobin variants on HbA1c measurements by the 4 methods were analyzed using Capillary 2 Flex Piercing as a comparative method. All statistical analyses were carried out using SPSS software version 19.0 . Mean bias were calculated for samples with hemoglobin variants, box plot was established to display bias distribution.ResultsHb New York showed no interference on the 4 HPLC mechods although Hb New York could not be detected. D-10 could detect 6 Hb variants, and showed clinically significant interference for Hb J-Bangkok, Hb G-Coushatta, and Hb G-Taipei. HA-8180V fast mode yielded no HbA1c values for Hb J-Bangkok, Hb G-Coushatta, and Hb G-Taipei. Hb E, Hb Q-Thailand, and Hb G-Honolulu produced significant negative biases for HA-8180V. G8 standard mode could detect 1 Hb variant, and showed significant negative biases for six Hb variants. MQ6000 Plus could separate six Hb variants, only Hb G-Coushatta and Hb G-Taipei produced significant negative biases for the system.ConclusionsSome common hemoglobin variants can interfere with HbA1c determination by the most popular methods in South China, which may lead to erroneous HbA1c values.（Chin J Lab Med, 2018, 41： 765-769）